Use of Interventional Neuroradiology Devices (Solitaire AB and Cascade Net) In The Treatment of Complex Renal Aneurysms Through Stent-Assisted Coil Embolisation.

2021 ◽  
Author(s):  
Eva Pampín ◽  
Fernando López Zarraga ◽  
Francisco Javier Maynar Moliner ◽  
Amaya Iturralde Garriz ◽  
Rebeca Bastida Torre
Keyword(s):  
Renal Artery ◽  
Interventional Neuroradiology ◽  
Stent Retriever ◽  
Coil Embolisation ◽  
Occlusion Balloon ◽  
Complex Aneurysms ◽  
Risk Of Rupture ◽  
Coil Migration ◽  
Flow Diverters

Abstract Introduction: The risk of rupture of true renal artery aneurysms is low but when they are bigger than 2 - 2.5 cm it increases significantly, making treatment essential. The need to use alternatives to conventional techniques in order to avoid predictable complications as coil migration is mandatory.Discussion: Routinely-used techniques in interventional neuroradiology such as flow diverters or those assisted with an occlusion balloon or stent have are suitable alternatives for complex aneurysms.Conclusion: Interventional neuroradiology devices such as the Cascade Net stent (Perflow Medical and Grupo Logsa) and Solitaire AB stent retriever (Medtronic) are valid and safe options. We describe the technique of such devices.

scholarly journals Ex vivo repair and renal auto-transplantation for treatment of a renal artery aneurysm after endovascular failure

2019 ◽  
Vol 12 (12) ◽  
pp. e231380
Author(s):  
Carlos Veiga ◽  
Rui Machado ◽  
Diogo Nunes-Carneiro ◽  
Rui Almeida
Keyword(s):  
Treatment Failure ◽  
Renal Artery ◽  
Endovascular Treatment ◽  
Ex Vivo ◽  
Artery Aneurysm ◽  
Renal Artery Aneurysm ◽  
Endovascular Techniques ◽  
Common Indication ◽  
Complex Aneurysms ◽  
Risk Of Rupture

Renal artery aneurysms are rare and typically found incidentally. Risk of rupture drives the incentive for repair, which can be achieved by both open and endovascular techniques. Ex vivo repair with renal auto-transplantation is recommended for complex aneurysms involving distal or multiple arteries. Here we describe a successful treatment of a renal artery aneurysm after previous endovascular treatment failure. A multi-layered stent was left misplaced inside of the aneurysm. Ex vivo repair with renal auto-transplantation allowed for complete aneurysm exclusion. With increasing use of endovascular techniques, failure of endovascular treatment might become a common indication for ex vivo repair in renal artery aneurysms.

Flow Diversion for Intracranial Aneurysm Treatment: Trials Involving Flow Diverters and Long-Term Outcomes

Neurosurgery ◽  
2019 ◽  
Vol 86 (Supplement_1) ◽  
pp. S36-S45 ◽  
Author(s):  
Bree Chancellor ◽  
Eytan Raz ◽  
Maksim Shapiro ◽  
Omar Tanweer ◽  
Erez Nossek ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Flow Diversion ◽  
Long Term Outcomes ◽  
Complex Aneurysms ◽  
Aneurysm Treatment ◽  
Endovascular Methods ◽  
Cure Rates ◽  
Flow Diverters

Abstract Flow diverters (FDs) have changed the management of brain aneurysms; not only for complex aneurysms (giant, fusiform and blister) refractory to conventional therapies, but also for unruptured lesions previously managed by traditional surgical or coil-based endovascular methods. Since 2011 when the PipelineTM Embolization Device (Medtronic) was cleared by the Food and Drug Administration for adults with large or giant wide-neck intracranial aneurysms of the internal carotid artery proximal to the posterior communicating segment, the role of flow diversion for aneurysm treatment has expanded—supported by favorably low complication and high cure rates compared with alternative treatments. Here we review the key clinical trials and the long term outcomes that have demonstrated safety and efficacy of minimized porosity endoluminal devices in the treatment of cerebral aneurysms.

scholarly journals Renal artery pseudoaneurysm: an unexpected mode of closure during coil embolisation

Heart Asia ◽  
2013 ◽  
Vol 5 (1) ◽  
pp. 220-221
Author(s):  
Srinivasa K Hemanna Setty ◽  
Rajiv Ananthakrishna ◽  
Manjunath C Nanjappa
Keyword(s):  
Renal Artery ◽  
Coil Embolisation ◽  
Artery Pseudoaneurysm ◽  
Renal Artery Pseudoaneurysm

Embolisation of Ruptured Cerebral Aneurysms with Interlocking Detachable Coils in Acute Stage

1997 ◽  
Vol 3 (1) ◽  
pp. 49-63 ◽  
Author(s):  
H. Manabe ◽  
S. Fujita ◽  
T. Hatayama ◽  
H. Ohkuma ◽  
S. Suzuki ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Acute Stage ◽  
Good Recovery ◽  
Coil Embolisation ◽  
Detachable Coils ◽  
Occlusion Rate ◽  
Technical Complication ◽  
Proximal Occlusion ◽  
Coil Migration

Twelve cases of ruptured cerebral aneurysm were treated in acute stage with interlocking detachable coils (IDC, Target Therapeutics, Fremont, California) and the outcome was assessed. IDCs were placed intra-aneurysm for intra-aneurysmal occlusion, or intra-artery for proximal occlusion. Cases: age 36–84 (mean; 60) y.o., 11 females and 1male; 1, 5, 4 and 2 patients were categorised (Hunt and Hess) as grades 1, 2, 3 and 4 respectively. An intra-aneurysmal occlusion in ten cases and a proximal occlusion in two were performed on day 1–11 (mean 4). On angiograms and CT findings, the ruptured point seemed to have occluded in all cases. The occlusion rate was 100% in five cases, 95% in two, 90% in three, 80% in one, and less than 50% in one. There were two cases of technical complication, one a coil migration and the other an aneurysmal perforation with IDC. Their Glasgow Outcome Scale six months after embolisation was graded as good recovery in four cases, moderately disabled state in two, severely disabled state in one, and dead in five. Follow-up angiograms taken four to six months after embolisation showed an intra-aneurysmal coil compaction in five cases. Two of these were treated by a second embolisation or by neck clipping followed by aneurysmal resection, but another two were observed without any treatment and the last one died of rebleeding. Histological examination of the resected embolised aneurysm revealed slight organization around coils but no endothelialisation over the aneurysmal orifice. In our experience, coil embolisation with IDC for acute ruptured aneurysm is a promising means of preventing rerupture during subacute stage.

scholarly journals Neurovascular reconstruction with flow diverter stents for the treatment of 87 intracranial aneurysms: Clinical results

2015 ◽  
Vol 21 (3) ◽  
pp. 292-299 ◽  
Author(s):  
Leonardo Giacomini ◽  
Ronie L Piske ◽  
Carlos E Baccin ◽  
Marcelo Barroso ◽  
Andrei F Joaquim ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Interventional Neuroradiology ◽  
Clinical Results ◽  
Flow Diverter ◽  
High Rate ◽  
Complex Aneurysms ◽  
Results Of Treatment ◽  
Silk Stent ◽  
Flow Diverter Stent ◽  
Aneurysm Occlusion

Background Flow diverter stents represent a new endovascular tool to treat complex aneurysms, such as giant, large, wide-necked and fusiform. The highly dense mash of these stents reduces inflow and outflow inside the aneurysm, resulting in intra aneurysmal thrombosis and stent endothelialization. Objectives To present the results of treatment of intracranial aneurysms with flow diverter stents in a single center. Methods Retrospective review of 77 patients with 87 aneurysms treated using two different types of flow diverter stent, the Pipeline Embolization Device and SILK stent, between October 2010 and September 2013 in an interventional neuroradiology center. Results Flow diverter stent placement was successful in 98% of the lesions and resulted in an immediate major stasis within most of the treated aneurysms. The overall aneurysm occlusion rate at six months and 18 months was 80% and 84% respectively. Symptomatic complications occurred in 11 patients (14.3%) with morbidity in eight (10.4%) and mortality in three patients (3.9%). Conclusion Flow diversion is a promising technique for treatment of challenging intracranial aneurysms with acceptable morbidity. A high rate of complete occlusion for small large necked aneurysms, a low morbidity and mortality rate and no recanalization encourage their use in these aneurysms. Further studies accessing long-term aneurysm occlusion and recanalization are required.

scholarly journals Use of Interventional Neuroradiology Devices (Solitaire AB and Cascade Net) in the Treatment of Complex Renal Aneurysms through Stent-Assisted Coil Embolisation

2021 ◽  
Vol 12 (11) ◽  
pp. 365-373
Author(s):  
Eva Pampín ◽  
Fernando López ◽  
Francisco Javier Maynar ◽  
Rebeca Bastida ◽  
Amaya Iturralde
Keyword(s):  
Interventional Neuroradiology ◽  
Coil Embolisation

Abstract 1122‐000071: Large and Giant Intracranial Aneurysms, Clinico‐Radiological Outcome and Predictors with Flow Diverter Stent

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Islam El Malky ◽  
Ayman Zakaria ◽  
Essam Abdelhameed ◽  
Hazem Abdelkhalek
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Flow Diverter ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Giant Aneurysms ◽  
Complex Aneurysms ◽  
Parent Artery Occlusion ◽  
Large And Giant Aneurysms ◽  
Flow Diverters

Introduction : Endovascular treatment for large and giant aneurysms has included either a reconstructive approach or a deconstructive approach by parent artery occlusion. 1,2 Stent‐assisted coiling and balloon‐assisted coiling were alternative techniques developed to deal with such complex aneurysms, but studies have shown less expected efficacy. This study aims to assess the safety and efficacy of the flow diverter stents for treating large and giant intracranial aneurysms and to examine possible predictors for radiological and clinical outcomes such as location and presence of branching artery, bifurcation, and adjuvant coiling. Methods : This study had been conducted on 65 consecutive patients with 65 large and giant aneurysms (size ≥ 10 mm) treated with flow diverters; Periprocedural complications were reported in all patients and clinical outcomes. Follow‐up angiography was done for 60 patients (92.3%) at 12 months. Results : The study included 65 patients who harbored 65 aneurysms. The median age was 55.5 years (IQR: 44.25 ‐ 62.75 years), the female represented 70.8 % of all patients. The clinical presentation had been reported (Headache, cranial nerve palsy, motor deficit, seizures, and visual field defect in 40 patients (61.5%), nine patients (13.8%), seven patients (10.8%), five patients (7.7%), and four patients (6.2%) respectively. The vascular risk factors had been reviewed (HTN, DM, smoking, and Hyperlipidemia in 25 patients (9.2%), Six patients (9.2%), sixteen (24.6%), and 10 patients (15.4%) respectively). The median size of aneurysms was 16.4 mm (IQR: 12.50 ‐ 23.85 mm) and the median neck width was 7.15 mm (IQR: 5.85‐10.24 mm). Fourteen aneurysms (21.4 %) had previous treatment, eleven aneurysms (16.9%) were treated by coils only, one case (1.5%) by assisted procedure, one case (1.5%) by previous FDS, and parent artery occlusion in one case (1.5%). Complete occlusion in 50 from 60 aneurysms (83.4%), neck remnant in 8 aneurysms (13.3%), and sac remnant in two aneurysms (3.3%). Periprocedural problems were encountered in 14 patients (21.5%) with morbidity in six patients (9.2%) and mortality in one patient (1.5%). Univariate and multivariate logistic regression analysis was used to discover possible predictors of combined mortality and morbidity and occlusion in Table (1). Conclusions : From this study, it could be concluded that Endovascular treatment of the large and giant aneurysms with flow diverters represents a safe method for treating this kind of complex intracranial aneurysms. Complex aneurysms with branching artery and bifurcation were associated with aneurysm persistence and complications respectively while the location of the aneurysm was the only predictor for clinical outcome.

scholarly journals Stent-assisted Coil Embolisation of Wide-necked Renal Artery Aneurysms

2013 ◽  
Vol 45 (2) ◽  
pp. 196
Author(s):  
M.-h. Kim ◽  
J.-s. Park ◽  
J.Y. Kim ◽  
Y.-k. Kim ◽  
S.-s. Yun ◽  
...  
Keyword(s):  
Renal Artery ◽  
Coil Embolisation

scholarly journals Coil Migration under Stent-Assisted Embolization

2006 ◽  
Vol 12 (1) ◽  
pp. 65-68 ◽  
Author(s):  
C.S. Cho
Keyword(s):  
Intracranial Aneurysm ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Effective Treatment Option ◽  
Parent Vessel ◽  
Complex Aneurysms ◽  
Delayed Complication ◽  
Detachable Coils ◽  
Neuroform Stent ◽  
Coil Migration

Detachable coils are established as a safe and effective treatment option for some patients with intracranial aneurysms. However this treatment is not useful for the treatment of certain types of complicated aneurysms. Wide-necked or broad-based aneurysms are still complicated to embolize because of the risk of coil migration or coil protrusion into the parent vessel. The Neuroform stent has recently been introduced for the treatment of complex aneurysms. The stent functions primarily to provide durable parent vessel protection during embolization. This report demonstrates coil migration occurring as a delayed complication of Neuroform stent-assisedt coil embolization of a small intracranial aneurysm.

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